       Document 0633
 DOCN  M9630633
 TI    The prevalence of sexually transmitted diseases in children and
       adolescents evaluated for sexual abuse in Cincinnati: rationale for
       limited STD testing in prepubertal girls.
 DT    9603
 AU    Siegel RM; Schubert CJ; Myers PA; Shapiro RA; Division of General
       Pediatrics, Children's Hospital Medical; Center, Cincinnati, OH, USA.
 SO    Pediatrics. 1995 Dec;96(6):1090-4. Unique Identifier : AIDSLINE
       MED/96095159
 AB    OBJECTIVE. To determine the prevalence of Chlamydia trachomatis,
       Neisseria gonorrhoeae, Trichomonas vaginalis, syphilis, and human
       immunodeficiency virus (HIV) infection in sexually abused children and
       to develop selective criteria for sexually transmitted disease (STD)
       testing in these children in our community. DESIGN. Prospective.
       SETTING. University-affiliated children's hospital in Ohio.
       PARTICIPANTS. All children evaluated at our hospital for sexual abuse
       were eligible. Eight hundred fifty-five children were evaluated over a
       1-year period. The study included 704 girls and 151 boys. Children
       ranged in age from 3 weeks to 18 years old. METHODS AND RESULTS.
       Standard STD testing (American Academy of Pediatrics recommendations)
       was defined as serum rapid plasma reagin test, examination for
       Trichomonas, N gonorrhoeae culture of the throat, rectum, and genitalia
       and C trachomatis culture of the rectum and genitalia. STD testing in
       this study was recommended in children with 1) a history of genital
       discharge or contact with the perpetrator's genitalia, 2) examination
       findings of genital discharge or trauma, and 3) all adolescents. HIV
       testing was obtained in children with risk factors for HIV infection,
       those with contact with a perpetrator with HIV risk factors, or if the
       family was concerned about HIV acquisition. A total of 423 children were
       tested for N gonorrhoeae, 415 for C trachomatis, 275 for syphilis, 208
       for Trichomonas, and 140 for HIV. Twelve children were determined to
       have N gonorrhoeae infection, 11 had C trachomatis infection, and four
       had Trichomonas infection. Overall, the prevalence of STDs in
       prepubertal girls was 3.2% and 14.6% in pubertal girls. The prevalence
       of N gonorrhoeae in prepubertal girls with vaginal discharge was 11.1%
       and 0% in prepubertal girls without discharge (P < .001). C trachomatis
       infection was diagnosed in 0.8% of prepubertal girls compared with 7.0%
       of pubertal girls (P < .001). None of the children tested positive for
       syphilis or HIV and no males had a STD. CONCLUSIONS. In our community, N
       gonorrhoeae testing in prepubertal girls can be limited to those with a
       vaginal discharge on examination unless other risk factors are present.
       The prevalence C trachomatis and Trichomonas in prepubertal girls is low
       and may be omitted from routine evaluations. All pubertal girls
       evaluated for sexual abuse should be tested for STDs because of the high
       prevalence of asymptomatic infection in this patient population.
 DE    Adolescence  Chi-Square Distribution  Child  Child Abuse,
       Sexual/DIAGNOSIS/*STATISTICS & NUMER DATA  Child, Preschool  Comparative
       Study  Female  Human  HIV Infections/DIAGNOSIS/EPIDEMIOLOGY  HIV-1
       Infant  Infant, Newborn  Male  Ohio/EPIDEMIOLOGY  Prevalence
       Prospective Studies  Sexually Transmitted Diseases,
       Bacterial/DIAGNOSIS/*EPIDEMIOLOGY  Sexually Transmitted Diseases,
       Viral/DIAGNOSIS/*EPIDEMIOLOGY  Urban Population/*STATISTICS & NUMER DATA
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

